摘要目的 追踪研究上海地区学龄儿童睡眠质量的变化趋势,进一步分析影响儿童睡眠质量的高危因素.方法 采用分层整群随机抽样方法,使用国际标准化儿童睡眠评估问卷(中文版CSHQ)于2005年与2009年对覆盖上海市城区和郊区的10个区县的同样10所小学的五年级学生进行问卷调查.其中2005年采用"区-学校-年级-班"的技术路线,抽取样本884人;2009年在2005年相同的10所小学以年级为最小单位进行调查,抽取样本2161人.主要对2005年以及2009年两个样本8种反映睡眠质量的参数进行比较分析,对影响睡眠质量的高危因素进行深入分析.结果 与2005年相比,2009年学龄儿童睡眠质量不良的比例由29.2%下降至27.9%,其中就寝习惯不良的比例由33.1%下降至28.7%、睡眠焦虑由50.6%下降至39.8%、夜醒由25.2%下降至21.5%、异态睡眠由51.2%下降至45.8%.校正年龄、性别以及家庭社会经济状况后,儿童睡眠质量较差主要与繁重的课业负担、平时使用电脑的时间过长、睡眠时卧房开灯、与父母/照养人同床睡、慢性疾病的影响及父母的作息习惯不良等有关.结论 上海学龄儿童睡眠质量整体近年来略呈上升趋势,但仍有1/4以上的儿童睡眠质量不佳.加强父母的睡眠卫生知识教育、帮助儿童养成良好的睡眠习惯,可能是最终改善儿童睡眠质量的有效途径.

abstractsObjective China has undergone massive socioeconomic change during the past several years, and its impact on children's sleep is still unrecognized.Shanghai, as one of typical economically fastdeveloping cities, was chosen as observational city in this study, which was designed to explore trends in sleep quality in Shanghai school-aged children and related high risk factors on sleep quality. Method Totally 884 fifth grade school-aged students were sampled by stratified cluster random sampling method from 10 primary schools of Shanghai in 2005, then four years later in 2009, 2161 same grade students were sampled from the same schools.Chinese version of Children's Sleep Habits Questionnaire (CSHQ) was used to evaluate 8 sleep quality parameters among those children, and high risk factors on school-aged children's sleep quality were investigated as well.Result The prevalence of poor sleep quality decreased from 29.2%in 2005 to 27.9% in 2009, and among 8 sleep quality parameters, bedtime resistance decreased from 33.1% to 28.7%, sleep anxiety from 50.6% to 39.8%, night waking from 25.2% to 21.5%, and parasomnia from 51.2% to 45.8%.The factors, such as heavier homework burden, longer daily computer use, bright light during sleep, cosleeping, existence of chronic disease and irregular sleep habits of parents,were associated with poor sleep quality of school-aged children after adjusting for children's age, gender, and family social-economic status.Conclusion Part of sleep quality parameters improved during the past 4 years, but current situation is still tough with more than 1/4 poor sleep quality children.Helping children to develop good sleep hygiene as well as educating parents how to shape children's regular sleep habits might be effective methods to improve children's sleep quality.